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Every year, a few hundred youngsters with severe dental decay end up at the Hospital for Sick Children, where he is director of the facility’s dental clinics.

According to a study released Thursday, every year, 19,000 Canadian children under age 6 suffer decay so extensive they need to go to hospital, be put under general anesthesia and undergo day surgery.

Seeing “brown, rotten stumps in mouths is fairly common,” remarked Casas, adding that a couple of times a year, he sees cases so bad he must extract all 20 of a child’s primary teeth.

“It’s uncomfortable for the child and uncomfortable for the parent … but it’s a common condition that for the most part is preventable,” he said.

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Filling or treating cavities and extracting teeth accounts for 31 per cent of all day surgeries for children between the ages of 1 and 5, making it the leading cause of day surgery for children in this age group.

The problem hurts Canadian taxpayers in the wallet, with hospital care alone costing $21.2 million annually, according to the CIHI report. On top of that, public dollars are also spent on dental surgeons and anesthesiologists.

Worse, the CIHI report reveals only part of the problem, since many other children are treated for severe decay at dentists’ offices and community clinics.

The consequences of rotting baby teeth — otherwise known as “early childhood caries” — can be dire, according to CIHI.

“Pain, difficulty eating and sleeping, speech difficulties and poor self-esteem may occur, affecting growth and ability to concentrate and function. Quality of life can be seriously impaired,” the report states.

In Ontario, 9,610 such operations were carried out during the fiscal years 2010-11 and 2011-12. The average yearly rate is 8.4 surgeries for every 1,000 children.

Ontario’s rate is lower than all other provinces and territories studied. (Quebec did not participate.) Nunavut’s is highest, with 97 surgeries for every 1,000 children.

Rates vary substantially across the province. In northwestern Ontario, there are 70 operations for every 1,000 children, compared with only 3.4 in Mississauga-Halton.

Carlos Quiñónez, director of the dental public health program at the University of Toronto’s dental school and a contributor to the report, said the high rate of decay is not simply a problem of children not brushing their teeth enough.

“This is a social disease, not simply a disease of behaviour,” he said.

Contributing factors include a lack of early childhood nutrition and dental care, fluoridation and availability of dental services.

The study found that day surgery rates are 3.9 times higher for children in the least affluent neighbourhoods, 8.6 times higher for those from communities with large aboriginal populations, and 3.1 times higher for children from rural areas.

Casas said he also sees children from middle-class families. Often the decay can be the result of children constantly having bottles full of milk or juice with them, even in bed. Children who breastfeed during the night and for longer periods of their childhood can also be at greater risk for cavities, he said.

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